POS1064 CLINICAL AND ECONOMIC BURDEN OF PATIENTS WITH PSORIATIC ARTHRITIS WITH AND WITHOUT AXIAL INVOLVEMENT
Authors: M. Bergman, J. Patel, C. Saffore, E. Mcdearmon-Blondell, I. Topuria, C. Cavanaugh
Journal: Annals of the Rheumatic Diseases (2022)

Background Axial involvement affects about 12% to 50% of patients (pts) with psoriatic arthritis (PsA), 1,2 and these pts report worse pain and function than pts without axial involvement. 3 Limited evidence exists quantifying the clinical and economic impact of axial involvement and pain in pts with PsA. Objectives To examine the clinical and economic burden of pts with PsA with and without axial involvement and assess the relationship between pain and frequency/costs of healthcare resource utilization (HCRU). Methods This cross-sectional study was conducted using de-identified linked electronic medical record and administrative claims data from the OM1 PsA Registry, a subset of the OM1 Real-World Data Cloud (OM1, Inc, Boston, MA, US). Adults aged ≥18 years with PsA (ICD-10 codes: L40.5x except for L40.53) were divided into two cohorts based on the presence or absence of the diagnosis code for axial involvement (ICD-10: L40.53) during 2019. Demographic and clinical characteristics between pts with and without axial involvement were compared with t-tests or Chi-square tests. Poisson regression models were used to assess the association of pain with HCRU. Mean costs per HCRU encounter (inpatient and emergency department [ED] visits) in 2019 were obtained from Optum’s de-identified Clinformatics Data Mart Database (2007-2019) and multiplied by the mean annual rate of HCRU encounters to generate per patient per year (PPPY) costs. Results Of 11,531 pts with PsA, 1,118 (10%) were diagnosed as having axial involvement. The two cohorts were similar in age, Charlson comorbidity score, and biologic disease-modifying antirheumatic drug (DMARD) use (Table 1). More pts with vs without axial involvement were commercially insured, had higher pain, and used opioids. Higher mean annual rates of inpatient (9 vs 5 per 100 pts) and ED (19 vs 14 per 100 pts) visits were seen in pts with vs without axial involvement, respectively, which translated to higher mean annual inpatient ($1,899 vs $1,055) and ED ($222 vs $164) visit costs PPPY (Figure 1). A 1-point higher pain score was associated with a higher likelihood of inpatient (52% vs 11%) and ED (20% vs 10%) visits (Table 1) and additional mean annual inpatient ($987 vs $116) and ED ($44 vs $16) visit costs PPPY (Figure 1) in pts with and without axial involvement, respectively. Table 1. Demographics, treatment utilization, and healthcare resource utilization Mean (SD), unless otherwise specified PsA pts without axial involvement n=10,413 PsA pts with axial involvement n=1,118 p-values Age, years 56.7 (13.0) 56.8 (14.0) 0.8948 Female, n (%) 6,401 (61%) 653 (58%) 0.0494 Insurance, n (%) &lt;0.0001 Commercial 3,285 (62%) 414 (73%) Medicaid 110 (2%) 18 (3%) Medicare 1,618 (30%) 103 (18%) Charlson comorbidity score 0.4 (1.0) 0.4 (1.0) 0.9900 Pain, VAS (0–10) 4.2 (2.6) a 4.5 (2.6) b 0.0422 bDMARD use, n (%) 6,871 (66%) 753 (67%) 0.3762 tsDMARD use, n (%) 1,117 (11%) 91 (8%) 0.0072 Opioid use, n (%) 1,722 (17%) 224 (20%) 0.0034 Inpatient visits/100 pts 5 (32) 9 (35) 0.0021 ED visits/100 pts 14 (63) 19 (72) 0.0168 Association of pain and HCRU, IRR (95% CI ) c Inpatient visits 1.11 (1.08–1.15)* 1.52 (1.13–2.03)** ED visits 1.10 (1.07–1.13)* 1.20 (1.05–1.38)** bDMARD, biologic DMARD; CI, confidence interval; IRR, incidence rate ratio; MTX, methotrexate; NSAIDs, non-steroidal anti-inflammatory drugs; SD, standard deviation; tsDMARD, targeted synthetic DMARD; VAS, visual analog scale. *p&lt;0.0001 and **p&lt;0.01 for association between 1-point increase in pain and HCRU. a n=9,981 b n=320 c Based on Poisson regression model adjusted for age, sex, race, insurance type, Charlson comorbidity score, and PsA treatments (b/tsDMARDs, MTX, and NSAIDs). Conclusion Axial involvement in PsA was associated with an increased clinical and economic burden. Higher pain was associated with higher HCRU and costs in pts with vs without axial involvement. References [1]Baraliakos X, et al. Clin Exp Rheumatic . 2015;33:S31–5. [2]Ogdie A, et al. J Rheumatol . 2021;48:698–706. [3]Mease PJ, et al. J Rheumatol . 2018;45:1389–96. Acknowledgements AbbVie funded this study and participated in the study design, research, analysis, data collection, interpretation of data, review, and approval of the abstract. No honoraria or payments were made for authorship. Medical writing support was provided by Julia Zolotarjova, MSc, MWC, of AbbVie. Disclosure of Interests Martin Bergman Shareholder of: JNJ (parent of Janssen) and Merck, Speakers bureau: AbbVie, Amgen, BMS, Janssen, Merck, Novartis, Pfizer, Sanofi, and Sandoz, Consultant of: AbbVie, Amgen, BMS, Janssen, Merck, Novartis, Pfizer, Sanofi, and Sandoz, Jayeshkumar Patel Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Christopher Saffore Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Erin McDearmon-Blondell Shareholder of: May own AbbVie stock or options, Employee of: AbbVie, Ia Topuria Employee of: OM1, Cristi Cavanaugh Employee of: OM1